Newborns of addicted mothers must endure painful withdrawal

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Rhode Island, which is reeling from a surge in opiate overdoses, got more disturbing news Monday: Health officials there revealed the rate of infants born dependent on drugs continues to rise after nearly doubling from 2005 to 2012.

The increase is considered to be one more ominous sign that abuse of drugs, particularly heroin and opiate painkillers, is growing in a state that already has recorded 90 overdose deaths this year.

“This is an example of the intergenerational tragedy in our state caused by the disease of addiction,” said Dr. Michael Fine, the state health director.

During the first three months of this year, 11 of every 1,000 babies born in Rhode Island were drug-dependent. That compared with 6.3 per 1,000 for the comparable period last year and 8.3 for all of 2012, according to preliminary data released by the state Department of Health.

Most addicted mothers are older than 30, white, and hold at least a high school diploma, health officials said, based on demographic data they analyzed. They also are more likely to be single and on public health insurance.

Much of that portrait may be at odds with the popular perception of drug addicts, said Garry Bliss, director of government and external relations for the Providence Center, which provides substance-abuse and mental-health services.

“It is not the face of addiction that most people picture, and it really speaks to the fact that addiction does not discriminate,” Bliss said. “People refer to what we’ve been experiencing as an overdose crisis, but what is underlying it is an addiction crisis.”

‘This is an example of the intergenera-tional tragedy in our state caused by the disease of addiction. ’

Infants born with neonatal abstinence syndrome, the condition that results from a mother’s dependence on opiates or other drugs, can suffer a wide range of side effects during withdrawal, health officials said. Authorities said 26 infants were born drug-dependent between January and March.

Symptoms can include excessive crying, tremors, and difficulty in coordinating sucking and swallowing, according to Dr. Marcia VanVleet, director of newborn services at Women & Infants Hospital in Providence. The condition is rarely fatal.

More than half of the infants born drug-dependent at Women & Infants Hospital are treated with morphine as they go through withdrawal, VanVleet said. The regimen differs from baby to baby, depending on what drugs and doses their mothers have been taking.

“You cut the cord, and they no longer have that constant infusion. Their receptors cry out for more,” VanVleet said. Withdrawal symptoms usually begin after three to five days in hospital stays that generally last two or three weeks, she said.

“All of these kids benefit from low noise, low light, kind of a soothing environment where they feel swaddled and contained,” VanVleet said.

Rhode Island and other states in the Northeast have been scrambling to respond to a recent surge in opiate overdoses, many of them from heroin that has been mixed with fentanyl, a powerful painkiller often used with end-stage cancer patients.

In Massachusetts, more than 200 people have died from suspected drug overdoses since November. Governor Deval Patrick declared a state of emergency in March to raise public awareness and divert funding to what he called a public health crisis.

Unlike Rhode Island, however, the Massachusetts Department of Public Health does not track births to drug-addicted mothers, said Anne Roach, a department spokeswoman. Similarly, the federal Centers for Disease Control and Prevention do not compile national data on such births, according to a spokeswoman.

In Rhode Island, VanVleet said that the drug habits of pregnant women are known and monitored by their obstetricians and treatment providers long before delivery. The run-up to labor can be wrenching.

“Most of the mothers that have gone through withdrawal themselves, they know that kind of creepy, crawly feeling under their skin,” VanVleet said. “They don’t want their newborns to go through this.”

Mothers who are addicted to painkiller medication are more difficult to track and counsel, VanVleet said, because many of them have not admitted that they have become dependent on the drugs.

Fine, the state’s health director, said the recent numbers show the need for support services for women at risk for addiction.

“Every baby deserves a healthy start,” Fine said. “We can and must minimize the devastating impact of neonatal abstinence syndrome,” partly through bolstering state services that provide prenatal home visits in Rhode Island and through the first few years of a child’s life.

VanVleet said she is not surprised by the increase in drug-addicted mothers, many of whom come from households that appear to be functioning well to outsiders.

“It’s no longer that chaotic family with no resources,” VanVleet said. “We also know that the women and the people that are getting addicted to drugs and addicted to pain medicine are . . . of child-bearing age.”

As a result, she said, “it does not surprise me that we will see more of this, and it will become more of a national epidemic if it isn’t already.”